Title : Cardinal signs in parkinson’s disease and agonists, antagonists, stabilisers
Abstract:
Background: Basal Ganglion Neuronal Network (BGNN) dysfunction in Parkinson’s disease (PD)is a complex one to explain Cardinal Signs (CS) satisfactorily. CS of PD are:
- Tremor,
- Rigidity,
- Bradykinesia and
- Postural Instability (PI).
Objective:
To propose adjunct explanation in PD in terms of Agonists, Antagonists and Stabilisers during movements.
Adjunct explanation proposal:
1.Rigidity: Co-contraction of Agonists and Antagonists.
2.Tremors: Alternate Agonists and Antagonists contractions
3. PI: Impaired involvement of Stabilisers
4. Bradykinesia: Reduction in numbers of Agonists and Antagonists taking part in motor programs.
In addition:
5.Dystonia: Unopposed strong Agonists
6.Freezing: Momentary jam of motor programs of all muscles involved (e.g. Freezing od Gait)
7.Dyskinesia: Automatic execution of sequential motor programs involving multiple agonists and antagonists in more than one part of a limb or more than one limb.
8. Apraxia: Total loss of normal sequence of motor programs
Conclusion: It is much easier to understand CS of PD using above explanation as an adjunct to dysfunction of BGNN.
Audience Takeaway:
- Above model of explanation can be used in adjunct to dysfunction of BGNN in teaching, patient education and understanding postural instability in PD.
- Therapist involve in PD management needs to engage all muscle groups (agonists, antagonists and stabilisers), Research using EMG of above muscles will shed more light on disturbance of synchrony among these muscle groups, Research on DBS affecting synchrony of above muscle groups.
